Final Thesis (Handed In)

P r o s t i t u t i o n a n d C o c a i n e | 1
Running Head: PROSTITUTION AND COCAINE
Prevalence of Cocaine Based Drugs
And Prostitution
Andre Encarnacao
Western Connecticut State University
JLA 405-71
Professor Gerbush
April 18, 2012

P r o s t i t u t i o n a n d D r u g U s e | 2
Part 1 - Thesis
The work field of the sex trade has many forms in today’s society, for example an exotic
dancer, a pornographer, and prostitutes all have one thing in common: they use sex to their
advantage to get paid in one way or another. The sex trade is also viewed as a lifestyle where
many use illicit drugs such as cocaine and heroin. Prostitution can cause a lot of mental distress
for the women who partake in it, and the women who use drugs along with selling their bodies
for sex are at even a higher risk to develop mental disorders. There are a few questions that need
to be asked in order to find a true correlation between prostitution and cocaine use; the first
question that needs to be addressed is why do women become prostitutes? As well as what leads
people to use cocaine? After answering these questions we will ask why cocaine use is so
prevalent in the work field of prostitution, or is it a misconception that many people share?
Part 2 - ResearchMethodology
Qualitative research is a method of research used for social sciences, and usually consists
of three methods; observation, interviews, and questionnaires. Qualitative research is used to
study a person’s or population’s behavior, seeking to answer the question of “why” in a
descriptive manner. It is a non-experimental method since it does not directly test for cause and
effect. The main purpose for qualitative research methods is to examine human behavior in the
contexts that the behavior occurs. Many of the questions that are being asked throughout this
process are open-ended questions that require much more than a yes or no, or an exact number.
Many of the answers given are complex and extremely difficult to code and organize properly.

Within the academic world of social sciences, qualitative research is becoming much more
popular due to the limits of other forms of research.
The articles being studied are from respected journals that are peer- reviewed, and
discuss the work field of the sex trade, with concentrations on prostitution and drug use. The
research questions being asked are focused on people’s perceptions and own experiences and
require detailed answers. These need to be open-ended questions, to allow researchers to have a
broader perspective of understanding, with the option of diving in deeper with the participants
involved in these case studies. For example, if a researcher asks a question of are you a
prostitute, if the question is answered with a yes the researcher is going to want to ask the
question of “why? And “how did you become a prostitute?” This allows for a broader
understanding of an overall situation in individual cases.
The phenomenon of prostitution is a global social issue, but for the purposes of this
assignment we will be mainly focused on the United States of America’s population. The states
that participants were used from are Florida, California, Texas, Connecticut, and Wisconsin. In
addition to the United States we will also discuss other countries with similar cultures such as
Canada and Australia.
Most of the journal articles being studied have very similar methodologies, and all look
to find the most plausible reasoning for such a high correlation between prostitution and drug
use. One of the methods used in one of the experiments, was to interview women that have been
sexually abused or arrested for soliciting prostitution, and disclose their drug habits during such
interviews. Women that have been in a drug rehabilitation program or arrested for cocaine use

were also asked correlating questions on the topic of prostitution. Some of the findings will
discuss the presence of heroin and marijuana, but for the purpose of this research we will be
focusing on the cocaine based drugs. Marijuana is actually the most widely used illegal drug in
the United States among most populations, regardless of social-economic status, but it is no
longer looked at as the social stigma that it once was, and will not be reported in these studies
unless needed to support the findings of cocaine abuse in the work field of prostitution.
Part 3 – The Researchand Connections
One of the questions that researchers frequently ask is if prostitution leads to drug use, or
if drug use leads to prostitution. In the United States, with the exception of the state of Nevada,
it is illegal to pay or receive payment for any sexual act. Because of these two independent
factors, studying the correlation between sex-trade and illegal drug use becomes increasingly
difficult within the United States since participants fear of openly admitting to taking part in
illegal activities. Most studies being examined were conducted by personal interviews or
questionnaires, with almost every participant signing a confidentiality agreement.
The status of prostitution, from a legal perspective, varies from country to country from
being considered a crime to a regulated profession. For countries such as the Netherlands and
Mexico, prostitution is legal and regulated, and some with even mandatory health checks.
However, for other countries such as India, Brazil, and Canada although prostitution is legal,
brothels and pimping, other forms of prostitution are illegal. These types of regulations help
prevent the exploitation of prostitutes.

Prostitution is also known as “the oldest profession” and is a secret habit of many men
and women in the world (Shutt, et al., 2011). Prostitution is a form of sex where romantic
emotions are not present, and this idea turns many onto the idea of having some desire to
experience this sexual phenomena. Most societies consider prostitution as a “wrong” in life, but
the ability to profit at such larger dollar amounts outweighs the moral judgment of some. The
people who take part in sex trade range from the very wealthy to the lower income customers.
It is important to not just look at females who are employees of the sex-trade, but also
how impacts males and the role they play in different situations, along with other factors that
might make an individual drive himself to take part in sex-trade or drug abuse beyond simple
recreational social purposes. Some of the mental distress that one might encounter while
partaking in prostitution would be pimping, mental harm, physical harm, and addiction to drugs.
Various types of prostitution are linked to different types of drug use. As an example call
girls or escort services with higher priced rates and a better “quality” of service are usually
supplemented by higher priced drugs and at a higher volume; the drugs that they are more likely
to use is cocaine. At the highest level of prostitution call girls and escort services are advertised
to a wealthier clientele (Sallmann, 2010). At one point Sallmann’s study stated that women’s
experiences of using substances and exchanging sex are “hidden in plain sight”.
Research findings indicate that, in the United States, more than half of street prostitutes
are drug users, who look to drugs as a mean to cope with the day to day stresses, emotional and
physical, that the profession may bring (Hunt, 1990). Prostitutes who are heavy drug users
often engage in crime to help support their habit (Hunt, 1990). Cocaine, as an example, is a

common controlled substance that is a felony to posses and distribute. It is one of the most
popular illegal drugs used by prostitutes in the United States, especially in the form of crack-
cocaine. Addiction to drugs causes such desperation, which at times leads women to exchange
sex for a small amount of drugs and sometimes being the start of their new way of living (Hunt,
1990).
If looking into prostitution or drug abuse, it would be a disservice to not look at
childhood trauma. Many mental disorders that certain adults experience, are derived from a
traumatic experience as a child that they have not been able to fully accept or cope with in their
own mind. To support this it is important to look at one study that directly looks at the
correlation of childhood trauma and adult prostitution; this particular study examines childhood
trauma and prostitution among multiethnic heterosexual drug using population (Medrano, 2003).
This study included 676 participants, and all of them were centralized in the city of San Antonio,
Texas. In this particular study the population is nearly 50% men and 50% women. It revealed
that 53% of women had exchanged sexual favors for drugs or money, and 35% of men reported
giving away drugs or money in exchange for sex (Medrano, 2003). Women were also more than
five times likely than men to experience “severe to extreme” abuse. The men were found to be
much more positively associated with buying sex if they had higher educational levels across the
ethnic board. One of the more interesting facts of this particular study is that black women and
men are much more likely to start using drugs or involve themselves in prostitution, than their
counterparts in the study that are Hispanics and Whites (Medrano, 2003).
A Canadian setting study looked at the different variables associated with prostitution and
the involvement of their women taking part in the injection of drugs intravenously. People that

are involved in prostitution only represent a small sample of their population (Spittal & Bruneau,
2003). Canada started to look into the problem of prostitutes suffering physical and emotional
harm in various settings, which eventually led to the disappearance of over 60 women in the
downtown Vancouver area (Spittal & Bruneau, 2003). In May 1996 this study recruited 1560
participants by self-referral and street outreach (Spittal & Bruneau, 2003). The requirements to
participate in this study were that you would have had to have injected an illegal drug at least one
time in the last month, and lived in the Vancouver area. Once participants were recruited to take
part in this study, they were required to provide a blood sample and a urine analysis. They then
had to return every six months for follow up questionnaires and blood tests (Spittal & Bruneau,
2003). The interview was based on a questionnaire conducted by an interviewer, and once
completed the interviewer would then ask follow up questions he or she felt appropriate. This
study found that 59% of the women that were interviewed and openly admitted to taking part in
sex-trade (Spittal & Bruneau, 2003). Only 4% of the participants ceased involvement in sex-
trade during follow ups (Spittal & Bruneau, 2003). The most popular drugs that were found to be
used were cocaine and its free base version of crack-cocaine (Spittal & Bruneau, 2003). The
results from this study indicate that women involved in the sex-trade were younger, and were
high dosage drug users who were more likely to live in unstable housing environments and to be
incarcerated at one point or another in their lifespan while being addicted to at least one illegal
drug (Spittal & Bruneau, 2003).
In South Wales, Australia researchers examined potential links between cocaine use and
street-based sex work. Illegal drug use was deemed common among street based prostitutes
(Degenhardt, 2006). Drug use is an important predictor in hypothesizing the future of a prostitute

(Degenhardt, 2006). In this particular study of South Wales street based prostitution, its main
question was to identify the more popular drugs being abused in this society where prostitution is
actually regulated. Police reports were analyzed and examined where drugs and prostitution was
at play, a series of semi structured interviews with key informants and known prostitutes among
the community were interviewed, as well as data that was collected via interviews with known
injection drug users were examined. The findings of the study found that trends in cocaine use
were very high (Degenhardt, 2006). Heroin at one point in the past seemed to be the drug of
choice by prostitutes in New Zealand, but more recent studies believe cocaine is more popular
with street level prostitutes in South Wales, New Zealand (Degenhardt, 2006).
The different roles that men and women play in the sex trade need to be examined as
well. Male sex workers are easy to spot anywhere in the world, yet they are almost completely
ignored by social service agencies, administrative bodies, mass media, and scholarship” (Dennis,
2008). The methods of one study took a sample of 166 recent articles that were published in
social science journals, where most did not mention the existence of male sex workers at all
(Dennis, 2008). The search contained keywords that would bring up relevant articles such as
prostitution, sex workers, male prostitution etc. To locate the articles being studied a search was
conducted on JSTOR and SocInfo, two of the largest social science databases that contain peer-
reviewed scholarly articles (Dennis, 2008). Most of the data analyzed were in nominal
categories, meaning that the answers received fit into a specific category. Based on the sample of
articles reviewed 84% discussed females only, 10% only males, and 6% discussed both. In the
discussion of the study it mentions that a great percentage of the male sex workers that were

looked at openly used cocaine, but did not provide a specific number or percentage (Dennis,
2008).
Another study that addressed the differences between men and women in the sex trade
looked at vulnerabilities and “trapping” that comes with the lifestyle of prostitution. Trapping is
defined as mutually reinforcing sex work and problematic drug use (Cusick & Hickman, 2005).
92 participants were used for this study out of 125 sex workers with experience with any illicit
drug. 80 of the participants were women, and 12 were men. 88% of the participants were found
through voluntary and statutory agencies providing services to sex workers, 4% were found
through sex worker advertising space, and 8% were referred to the study by snowball sampling.
43% were between the ages of 18 to 24, and 53% were 25 years of age or older (Cusick &
Hickman, 2005). One hour long interviews were conducted between April 2001 and May 2002,
and quantitative data was collected through a questionnaire on topics of drug use patterns and
sex work. The questionnaire was conducted orally, with semi-structured interviews comprising
of open and close ended questions. After interviews were conducted the sample was split into
two different categories, outdoor drifting and indoor entrepreneurial. Outdoor drifting refers to a
sex worker stereotypically standing on a street corner, and indoor entrepreneurial sex worker is
referred to as the stereotypical “high class” prostitute (Cusick & Hickman, 2005). The findings
were that the outdoor drifting experiences left the sex workers much more vulnerable to drug
use, and other negative experiences such as physical abuse. 72% of the workers that were
classified as drifting had a high risk of becoming “trapped”, were 18% of indoor sex workers
were at high risk (Cusick & Hickman, 2005).

Out of all the journal articles that were examined, the one that stands out with such
compelling findings attempted to find the connections between prostitution and substance abuse
in general. Studies consistently report high illegal drug use within samples of prostitutes (Dalla,
2000). This study found that it was much more common for women to become involved in
prostitution when they are already addicted to a certain street drug, but of course there are the
cases in which they develop a substance abuse issue either simultaneously or with their entrance
into the profession of prostitution. Any method of drug abuse will encourage drug use to cope
with emotional or physical stressors. (Philaretou, 2006). Multiple individuals who took part in
this study found that they were using cocaine on a recreational basis, and once becoming
involved in prostitution they graduated to crack-cocaine. In this particular study 86% of the
women involved took part in consuming illegal drugs. A study that was looked at within
Sallamann’s literature review found that 92% of those involved with prostitution used a cocaine
based substance, versus the 62% that was no longer trading sex (El-Bassel et al., 1997). Nearly
half of the women who took part in Sallmann’s study described their connection between their
substance abuse and prostitution as “a means to an end” (Sallmann, 2010). 30 percent of the
women reported that they began prostituting while having a pre-existing addiction to either
cocaine or crack-cocaine, nearly all of them said that prostitution was a easy way out to pay for
drugs quickly (Sallmann, 2010).
If somebody says they don’t, they, they’re lying. [Interviewer: . . . they don’t?]
Exchange sex for drugs, they’re lying. They’re lying to your face. If you have a
habit on any level, you’ll do whatever it takes to get that that met. So you’re not
sick. Or so that you don’t have the shakes or whatever. I don’t care if you’re

dealing with alcohol or drugs, same difference. You’ll do what you have to do to
get those needs met.
This was a powerful quote by a participant in Sallamann’s interviews, discussing the
power of addiction, and the possible “wrongs” that you might commit to get your fix once
addicted (Sallmann, 2010).
At first (sigh) I was I was really uncomfortable with prostitution. But, it took care
of the immediate needs, you know. And, I didn’t do drugs at the time. At that
time I would just do prostitution when I needed, you know, just enough to get,
you know, food and to pay for the room that I was staying at. And, within about a
month, um, I had been around all these other girls and, you know, they were
always passing a crack pipe. And one day I decided to take it. I thought at the
time that, you know, I was protecting both my children by leaving my husband
and I wound up puttin’ them both in a worse situation. And ah, due to what I was
doing. Ah, both the prostitution and the drugs that I was doing because I was
uncomfortable with what I was doing. That’s why I used the drugs. It was to
make it easier to do. To do that.
This quote by a participant in the Sallmann study shows one women’s situation of taking
part in prostitution with no plans of drug use, but with time was eventually sucked into the life as
a prostituting crack addict (Sallmann, 2010).
In the last 150 years substance abuse has been looked at through many different studies
as a way of coping or dealing with the stress and emotional fragility of women working as
prostitutes (Kandall, 1996). The relationship between drugs and prostitution is expressed in

many factors but primarily both businesses feed off of each other. Sallmann’s study interviewed
women who had previously been involved in prostitution and were addicted to drugs. The study
found that most women described the relationship between the two as “going hand-in hand” and
that their addiction complemented their job so easily that they were able to justify the drug use as
a method of coping with the harsh settings (Sallmann, 2010). Many of the women involved in
prostitution are looked at as victims, since males seem to hold so much more “street power” and
often intimidate the women to continuing their work as prostitutes (Dennis, 2008).
Prostitutes turn to drugs to weaken their feelings of guilt or wrong doing for selling their
bodies as a sexual object, rather than look at themselves as a respectable individual. Although it
remains unclear whether drug use leads to prostitution or vice versa, certain patterns are clear
based on research studies. One study conducted by Romero-Daza shows that there is a common
theme of violence that constantly runs through the lives of women involved in prostitution. By
focusing on the life experiences of the different women engaged in prostitution, especially at the
street-level, another study attempted to fill gaps in previous research by interviewing different
street-level prostitutes in an inner city Hartford, Connecticut location. With little social support
and limited mental health services available, women who, throughout their lives, have
experienced continuous domestic abuse find temporary relief in the use of drugs. Once addiction
progresses and the demand for drugs increases, the lack of viable economic alternatives and lack
of female centered and oriented drug abuse programs often lead or pave the way for women to
enter into prostitution (Romero-Daza, et al., 2003). Researchers looked at the relationship
between violence, drug abuse and prostitution in a group of inner-city women involved in street-
level prostitution (Romero-Daza, et al., 2003). 35 women who were known prostitutes were

interviewed with open ended questions and were asked to fill out questionnaires. To qualify as a
prostitute for this individual study, you must have exchanged sex for money or drugs directly.
All of the women reported used multiple drugs, including heroin, cocaine, and speed balls,
which is a mixture of the two together injected intravenously. Speed balls are also one of the
most common ways any person overdoses on drugs. The mixture of uppers and downers create a
stress on the heart that sometimes causes cardiac arrest or stroke, sometimes leading to death
(Oselin, 2009). The women that were included in this project were regular users of illegal drugs,
and some have argued that focusing on drug use among women involved in prostitution just
contributes to the negative stereotypes that I plan to prove to be true.
Much of the previous research, suggests that women who engage in prostitution have a
high rate of drug abuse among their population (Young et al, 2000). With the different reasons
and explanations as to why women enter into prostitution, the most popular in one study shows
that drug addiction was the most popular (Young et al, 2000). The objective of this particular
study was to investigate and examine how actions involved with prostitution might affect the
severity and nature of the women’s drug use (Young et al, 2000). Researchers conducted a
secondary analysis of a 1992-1995 data set pertaining to women’s crack cocaine use. To be
included in this analysis women had to consume at least $100 of crack cocaine within a week on
a regular basis - 203 women took part in this particular study as well as took part in open ended
interviews.
One of the more interesting points and comparisons made within this certain study was
that comparison made between women who admitted to being involved with prostitution versus

women who did not take part in it. The women who took part in prostitution on average
consumed more than one drug besides crack within the last week. Excluding marijuana, heroin
and cocaine based drugs were the most popular (Young et al, 2000). The findings of this study
indicate that the severity of substance abuse and addiction are directly related to prostitution
among the sample taken. If it was found that the individual woman was not a crack user prior to
entering prostitution, she was almost a certainty to experiment with the drug at one point
another, either for recreational purpose or to cope with the stress factors associated with the
lifestyle of a prostitute (Young et al, 2000).
Researcher Dana E. Hunt did one study with a sample of 30 women currently working in
the prostitution business and also current users of crack. They were offered $20 for the survey,
which lasted about an hour. The women were asked questions about many aspects of their lives
including drug use, experience with violence, and sex trade. The findings showed that persons
who abuse drugs, particularly expensive drugs such as cocaine and heroin, are more likely than
nonusers to be involved in a lifestyle that includes a great variety of illegal activities, from
property offenses to confidence games and prostitution (Hunt, 1990). Hunt’s research findings
indicate that more than half of street prostitutes are drug users. Prostitutes who are heavy drug
users often engage in crime to help support their habit.
One study that was conducted by the University of Nebraska examined the exit from
prostitution attempts of 43 street level prostitutes (Dalla, 2006). Three years after initial
meetings, interviews were conducted and coded, which gave Rochelle Dalla all the information
she needed to answer her questions regarding the exits of the profession by street level

prostitutes. Many connections were made directly with cocaine use, and prolonged period of
time participating in prostitution, with nearly all of the women re-entering into the profession or
prostitution at some point in their life, due to an endless amount of circumstances that drive them
to need the income (Dalla, 2006). 5 of the women interviewed described significant events that
culminated in them hitting “rock bottom” and eventually forcing themselves to leave the sex
trade business. These significant events range from rape, serious assault by a client, and one
spoke of the seriousness of the withdrawals she would go through when experiencing a de-tox
(Dalla, 2006).
Sharon Oselin also looked at the exit from prostitution by way of a rehabilitation
program. The Prostitution Rehabilitation Program (PRP) is a 29 year old non-profit organization
that assists people who once took part in prostitution to re-integrate into a normal society, and
place individuals in certain programs based on their individual needs (Oselin, 2009). The
findings of this study were that with increased supervision and guidance, the chances of a
woman successfully exiting the world of prostitution is very possible, but women who left
program early were nearly given that they would return to prostituting (Oselin, 2009). The
particular program by the PRP that focuses on straightening out the life of prostitutes takes place
not over weeks or months, but rather it takes place over years with each phase taking months at a
time. Just like drug use, to recover from prostitution emotionally and physically, one might need
years of supervision and counseling to enable the individual on the right path back to a
contributing member of society. The effect on one’s self perception becomes extremely altered
once giving themselves away and involving in drug use to deal or cope with the distress (Wesely,
2003). Many prostitutes ask themselves the question of “Where am I going to stop?” multiple

times a day, but their lives are so drenched in the world of prostitution that they convince
themselves that they’ll exit in a week, but find reasons condoning their behavior (Wesely, 2003).
Part 4 – Conclusion
Overall, research showed that there was a strong correlation between cocaine abuse and
prostitution. Higher scale prostitutes like call girls or escort girls were more commonly addicted
to a more expensive version of cocaine in powder form, with accessibility to larger amounts. On
the street level of prostitution, common drugs associated with them were crack-cocaine, and
heroin. At the legal level of prostitution or, stripping there were various types of drugs ranging
from cheap to expensive. Most women who participated in the studies that were examined
consumed marijuana. Cocaine based drugs also seem to be used to heighten the level of sexual
pleasure, and also a mood lifter in attempt to reach a sense of euphoria in the world of sex trade.
One cannot confirm whether prostitution directly leads to drug use or vise versa, mainly
due to the multiple independent factors that can lead up to create one’s circumstances. Each
individual case and circumstances are different, and it is not fair for others to group the women
together in this case. Many of these women have encountered horrid physical and emotional
abuse, prior to drug use or starting of prostitution. However, there is undoubtedly a correlation
between drug use and prostitution. Research shows that they go hand in hand and in many
circumstances cause one another. The cause and effect relationship can go both ways. As seen in
many case studies, prostitutes have become drug users through their time on the job. The stresses
of prostitution, its environment and the mental disorders coming from the detachment from
abuse of being a prostitute are all factors leading to drug use and the numbing effects that drugs

have. Adversely, female drug users with strong addictions turn towards prostitution to support
their habits. The cost of cocaine products are usually on the expensive side and most individuals
do not have means to maintain their addiction therefore depending on their sexual partners and
income from prostitution. Being in an environment where prostitution is present, drug users find
is easy to get into the life of prostitution whether they are forced to in order to pay off their debts,
or doing it voluntarily to make money to buy drugs.
Through analysis of the various studies discussed above, I hope to have contributed to the
understanding of the overall epidemic of prostitution and drug abuse. Although some studies
suggest that drugs are a precursor to prostitution, others negate those findings. The question of
which comes first, the drugs or prostitution, remains unclear. However, one conclusion could be
made quite definitely; prostitution and illicit drug use often go hand in hand.

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